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Inicio Medicina Clínica (English Edition) Substance use disorder: Epidemiology, medical consequences and treatment
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Vol. 162. Issue 9.
Pages 431-438 (May 2024)
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Vol. 162. Issue 9.
Pages 431-438 (May 2024)
Review
Substance use disorder: Epidemiology, medical consequences and treatment
Trastorno por uso de sustancias: epidemiología, complicaciones médicas y tratamiento
Daniel Fuster
Corresponding author
dfuster.germanstrias@gencat.cat

Corresponding author.
, Paola Zuluaga, Robert Muga
Unidad de Adicciones, Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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Tables (6)
Table 1. Criteria for substance use disorder according to DSM-5.
Table 2. SUD neuroadaptation phases.
Table 3. Main complications associated with the use of the most prevalent addictive substances.
Table 4. Symptomatology and treatment of the main addictive substance withdrawal syndromes.
Table 5. Pharmacological treatment for alcohol use disorder.
Table 6. Pharmacological treatment for opioid use disorder.
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Abstract

Substance use is a common health problem, and substance use disorder, which is its most severe presentation, is associated with multiple medical consequences and a negative impact on individual and on population health. Substance use disorder needs to be addressed as any chronic medical condition; therefore, it has to be detected at the early stages and has to be properly treated to prevent drug-related harm. Internists should be able to recognize and treat intoxication and abstinence. Internists should also be able to refer the patient to state of the art long term treatment, aimed to detoxification and treatment induction to promote abstinence and prevent relapse. In this narrative review we will discuss substance use epidemiology, its main medical consequences and its treatment, with a focus on alcohol, opiates, cocaine and other stimulants, cannabis and benzodiazepines.

Keywords:
Substance use disorder
Alcohol
Opiates
Cocaine
Cannabis
Benzodiazepines
Epidemiology
Medical consequences
Treatment
Resumen

El consumo de sustancias adictivas es un problema de salud prevalente, que en su forma más extrema, el trastorno por uso de sustancias, se asocia con consecuencias médicas que tienen un impacto negativo en la salud, tanto individual como poblacional. El trastorno por uso de sustancias debe ser abordado como cualquier otra enfermedad crónica; así, ha de ser identificado de forma precoz y debe ser adecuadamente tratado para evitar consecuencias futuras. El médico internista está capacitado para reconocer y tratar las consecuencias inmediatas de la intoxicación o la abstinencia. También ha de remitir al paciente a recibir un tratamiento adecuado, tanto de desintoxicación como para mantener la abstinencia y evitar la recaída en el consumo. En esta revisión narrativa discutiremos la epidemiología, las principales complicaciones del consumo perjudicial y el tratamiento más adecuado del trastorno por uso de sustancias, con énfasis especial en el alcohol, opiáceos, cocaína y otros estimulantes, cannabis y benzodiacepinas.

Palabras clave:
Trastorno por uso de sustancias
Alcohol
Opiáceos
Cocaína
Cannabis
Benzodiacepinas
Epidemiología
Complicaciones médicas
Tratamiento

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